Welcome! The following information will help us to set up and maintain a file for your pet. Thank you!

Your Information
Pref Contact
Responsible Party (In case of an emergency)
Nearing relative not living with you (Other than listed above)
Other person(s) authorized to present pets for treatment
Pet's Information
Sex
Spay/Neuter
Vaccinations Current?

I agree that, Newport Harbor Animal Hospital and its employees may take and use photographs of me and/or my pets, with or without my name, only for such purposes as publicity, illustration, advertising, and Web content.

It is our policy to provide you with an estimate of charges for any medical treatment, surgery, or hospitalization that will be provided. A deposit may be required prior to treatment, based upon the amount of the estimate.

Acceptable forms of payment are: Cash, Visa, MasterCard, American Express, Discover, and CareCredit.

*ALL CHARGES ARE DUE AND PAYABLE UPON PATIENT’S RELEASE